Feb 21, 2019
Chris Sloan is an
associate principal at Avalere Health, a Washington, DC–based
nonpartisan consulting firm. He advises a number of
clients—including pharmaceutical manufacturers, health plans,
providers, and patient groups—on key policy issues facing the
health care industry. His particular areas of expertise include
drug pricing, the Affordable Care Act, generics, and biosimilars.
Additionally, Chris is a recognized expert in the health care
policy issues facing people living with HIV/AIDS and multiple
sclerosis. Chris’s economic analyses of key policy proposals and
issues, including drug pricing and the repeal and replace efforts
around the Affordable Care Act, have been featured in a wide range
of publications such as the Wall Street Journal, the
New York Times, Politico, Vox, and others. He has a BBA
degree in economics and marketing from the College of William and
Mary.
01:12 The HHS proposal.
02:29 “Rebates are a really big part of Medicaid Part D.”
02:45 What the “follow the dollar” looks like in this scenario.
04:10 How rebates between PBMs and manufacturers work, and how list
prices play into this.
05:26 How this system can hurt the patient, and how this new
proposal works to change that.
06:37 Pricing a product as a PBM.
08:04 The total dollar value of PBM rebates.
11:24 Do we know how much PBMs are making in incentives?
14:08 Are PBMs helping or hurting the process?
17:13 Why pharmaceutical managers may be more compelled to raise
their prices thanks to large PBMs.
18:10 Perverse incentives in the system.
18:55 “At the end of the day, PBMs are still going to be employed
by health plans.”
20:29 How a new model is combating the perverse incentive that
raises prices for patients.
23:45 The trade-off involving premium prices in this new
proposal.
26:13 “We’re not talking astoundingly large amounts of money.”
26:46 Why PBMs and health plans are against this proposal.
27:37 Why Pharma is for this.
29:11 The perverse incentives for health plans.
31:00 The benefit of Part D.
31:46 The advantage of huge rebates.